Influenza Immunization at Midlife and the Risk of Parkinson Disease
Notice bibliographique
Résumé
Importance: Influenza infection could be associated with a long-term increase in the risk of Parkinson disease (PD). However, the benefit of influenza immunization as a preventive measure for PD remains unknown. Objective: To assess whether immunization for influenza at midlife (between age 40 and 50 years) is associated with a decreased risk of PD. Design, Setting, and Participants: This cohort study used electronic medical records from the UK's Clinical Practice Research Datalink Aurum. The study cohort comprised individuals vaccinated for influenza between 40 and 50 years of age (hereafter, with influenza immunization at midlife) from 1995 to 2017 and unvaccinated controls (hereafter, without influenza immunization at midlife) matched 1:1 on age, sex, socioeconomic status, and calendar month of the vaccination. All analyses were conducted between January and May 2025. Main Outcomes and Measures: The primary outcome was incident PD. A modified intention-to-treat exposure definition with a 2-year lag period was applied to assess the risk of incident PD associated with influenza immunization at midlife vs no influenza immunization at midlife. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% CIs of the study outcome. Inverse probability of censoring weighting was used to account for selection bias, and propensity score matching was used for confounding control. Secondary analyses assessed potential effect size modifiers. Sensitivity analyses explored the implications of different potential biases. Results: The study cohort included 1 191 209 individuals (mean [SD] age, 44 [3] years; 673 920 females [56.6%]), of whom 612 974 received influenza immunization at midlife and 578 235 did not receive influenza immunization at midlife . Influenza immunization at midlife vs lack thereof was not associated with the risk of PD overall (crude incidence rates per 1000 person-years, 0.16 vs 0.10; matched HR, 0.96; 95% CI, 0.76-1.22). Results varied over time, with the lowest point estimate approximately 8 years after vaccination (HR, 0.75; 95% CI, 0.52-1.08), but none of the differences were statistically significant. Results also varied by seasonality, with a lower point estimate for those vaccinated during influenza season (matched HR, 0.62; 95% CI, 0.33-1.15) compared with those vaccinated outside of influenza season (matched HR, 1.07; 95% CI, 0.81-1.42). Stratification by age, sex, or vaccination prior to cohort entry did not modify the association. Sensitivity analyses supported the findings of the primary analysis. Conclusions and Relevance: This cohort study found that influenza immunization at midlife was not associated with the risk of PD in the overall population. Potential benefits for PD risk occurring several years after vaccination or in specific patient subgroups require further investigation.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».